Organization
PELHAM SUPPORTIVE SERVICES
Active
Organization
PELHAM SUPPORTIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILDRED C WILSON (DIRECTOR)
(910) 630-6757
Entity
Organization
Contact information
Practice address
949 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301-2907
(910) 630-6757
(910) 884-9806
Mailing address
949 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301-2907
(910) 630-6757
(910) 884-9806
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-026-823
NC
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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